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Delaware mental health services get more oversight

Sen. Bethany Hall-Long, a Middletown Democrat and nursing professor at the University of Delaware, co-chaired the Behavioral and Mental Health Task Force, which the state convened last year.(Photo: JASON MINTO/THE NEWS JOURNAL)Buy Photo

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Delaware is tasked with creating a system that promotes community-based mental health treatment.

The state convened a Behavioral and Mental Health Task Force last year.

An estimated 1 in 5 adults in the state has a mental or behavioral health issue.

Behavioral and mental health services in Delaware will face more scrutiny under a public-private commission signed into law Tuesday.

Flanked by mental health advocates and state health leaders, Gov. Jack Markell signed legislation launching a Behavioral and Mental Health Commission and an independent review committee that will monitor incident reports at area psychiatric hospitals and treatment records of adults suffering from serious and persistent mental illnesses, including schizophrenia, bipolar disorder and severe depression.

The purpose of the review committee, comprised of private health professionals and staffers of government health agencies, is to provide ongoing oversight and achieve long-term compliance with a 2011 settlement reached between Delaware and the U.S. Department of Justice, according to the legislation's proponents.

Under terms of the agreement, Delaware was tasked with creating a statewide mental health system that promotes community-based mental health treatment over lengthy hospital stays. It stemmed from violations of patient civil rights uncovered at Delaware Psychiatric Center, the subject of a 2007 investigation by The News Journal.

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Rita Landgraf, secretary of the Delaware Department of Health and Social Services, is shown at the Cheer Center in Georgetown on June 7.(Photo: JASON MINTO/THE NEWS JOURNAL)

Washington, D.C.-based consultant Robert Bernstein, who is responsible for evaluating Delaware's progress since the settlement, praised the state for its crisis hotline and community walk-in centers in his most recent December report. But Bernstein also cited a 30 percent increase in weekly psychiatric hospitalizations — rather than mandated decreases — since the start of the settlement.

Jim Lafferty, executive director of the nonprofit Mental Health Association in Delaware, hopes the new commission will be more "transparent" in identifying gaps in the system, such as limited access to mental health care for people with developmental disabilities.

"We need to be sure that no matter who you are, you're getting the same care and quality of care, regardless of your ability to pay," he said.

The state convened a Behavioral and Mental Health Task Force last year after Christiana Care Health System shuttered the Herman Rosenblum Child and Adolescent Center in Wilmington and moved mental health providers into the hospital's primary care offices. It's unclear whether Delaware has fully recovered from the loss in outpatient services, according to Lafferty.

An estimated 1 in 5 adults in the state has a mental or behavioral health issue. The same is true for about 9,000 children. Establishing a permanent mental health commission was one of several recommendations for system reform by the mental health task force, co-chaired by Sen. Patricia Blevins D-Elsmere and Sen. Bethany Hall-Long, a Middletown Democrat and nursing professor at the University of Delaware.

Previously, the state Department of Health and Social Services was charged with monitoring quality control and access issues related to mental health treatment. Providing a range of "cradle-to-grave" services requires outside input, Hall-Long said.

The recommendations of the review subcommittee and the larger 21-member commission, are not binding, but Health and Social Services Secretary Rita Landgraf expects legislators to listen.

If the commission found a high number of patient deaths at one psychiatric facility, for instance, members could recommend revoking that facility's license, Landgraf said. The review subcommittee will have access to investigatory files that will remain confidential, she said. The commission's recommendations, however, are expected to be made public.

In other action Tuesday, Markell signed legislation codifying a state Suicide Prevention Coalition, founded in 2004 by the Mental Health Association. The coalition of public and private health leaders raises awareness of suicide as a preventable health problem and analyzes statistical data. In Delaware, someone dies by suicide about every 3.5 days. Among those aged 15-24, suicide is the second leading cause of death nationwide.

Last year, the state mandated that Delaware public school teachers complete 90 minutes of suicide-prevention training.